The Centers for Disease Control and Prevention's (CDC) Youth Risk Behavior
Surveillance System (YRBSS) indicates that young people are at risk of
a number of serious health problems, including sexually transmitted diseases
and HIV/AIDS. The most recent YRBSS survey of high school students (Kann
et al., 1996) reported that 53% have had sexual intercourse and 38% are
currently sexually active (defined as having had intercourse during the
preceding 3 months). Slightly over half of adolescents reported using a
condom during last sexual intercourse, with African American students significantly
more likely than Hispanic or white teens to report condom use at last intercourse.
Given the relationship between drug use and impaired judgment, it is alarming
that more than half of students reported recent alcohol use, and one-fourth
reported recent marijuana use.

Experts agree that prevention through education is the best way to fight
the transmission of human immundeficiency virus (HIV), which causes AIDS,
and that education must begin before young people initiate sexual activity
and certainly no later than seventh grade (Black & Jones, 1988; Kirby,
Barth, Leland, & Fetro, 1991; White & Ballard, 1993). Because school
attendance is a nearly universal experience for American children and youth,
schools offer an accessible and appropriate setting for HIV/AIDS education.
Unfortunately, the capacity of teachers to provide instruction about AIDS
and other related health problems with knowledge and comfort may be limited
by a lack of preservice education.

THE EXTENT OF PRESERVICE HIV/AIDS EDUCATION

Despite the fact that most elementary health education is provided by
regular classroom teachers, only 31 states require elementary teachers
to have health coursework (Stone & Perry, 1990). Most health education
at the secondary level is provided by certified health teachers, although
a recent survey found that one-third of secondary health teachers majored
in a field other than health or science (Collins, Small, Kann, Pateman,
Gold, & Kolbe, 1995). For this reason, Guidelines for Effective School
Health Education to Prevent the Spread of AIDS called upon colleges of
education to provide preservice AIDS education for future teachers (CDC,
1988). The following studies suggest a lack of HIV-specific training in
preservice teacher education:

*In one study of 197 institutions of preservice teacher education, only
54% of elementary-emphasis students and 58.1% of intermediate-emphasis
students remembered receiving any planned instruction regarding HIV (White
& Ballard, 1993).

*A study of college catalogs conducted by the Sexuality Information
and Education Council of the United States (SIECUS) concluded that no universities
required a sexuality education course for preservice teachers, and only
14% required all preservice teachers to take a health education course
(Rodriguez, Young, Renfro, Asencio, & Haffner, 1995/96).

THE NEED FOR COMPREHENSIVE PRESERVICE HIV/AIDS EDUCATION

Six factors related to HIV/AIDS make preservice preparation critical:

1. Children with HIV disease are living longer, and the number of children
with HIV/AIDS who are attending school is expected to grow. Teachers need
an understanding of the special educational, social, psychological, and
medical needs of these students.

2. Since 1993, HIV/AIDS has been the leading cause of death among 25-
to 44-year-olds in the United States (Update, 1996). Teachers may expect
to confront educational and psycho-social issues among children whose parents
have HIV disease.

3. To prevent the spread of any disease, teachers must be knowledgeable
and skilled in using correct infection control guidelines in and around
the classroom.

4. In some instances the teacher may be entrusted with information about
a student's, parent's, or staff member's HIV status and must understand
ethical and legal requirements for respecting confidentiality.

5. Teachers may be expected to provide HIV/AIDS education and to answer
students' questions about HIV disease in a manner that is developmentally
and culturally appropriate.

6. Teacher attitudes affect their comfort with and capacity to teach
specific subject matter. The preservice setting offers an opportunity for
future teachers to explore their own beliefs and biases toward the disease.

CURRENT EFFORTS TO INCLUDE HIV/AIDS PREVENTION EDUCATION IN PRESERVICE
TEACHER EDUCATION

HIV/AIDS education can have a significant impact on college students.
For example, in one study, participants in an elective course on the HIV/AIDS
epidemic exhibited decreased homophobic attitudes, became more tolerant
towards persons with AIDS, and improved knowledge about AIDS. However,
there was no change in their perception of personal vulnerability (Goertzel
& Bluebond-Langner, 1991).

Although less than one-third of preservice teacher education students
in another study felt that HIV/AIDS prevention education should be taught
in a separate course (Quinn, Thomas, & Smith, 1990), several universities
have developed specific courses for teacher education students. For example,
a course at the University of Florida called "HIV/AIDS Education: Issues
& Strategies," was developed for not only preservice teachers but for
students in social work, nursing, premedicine, allied health, and social
and behavioral sciences (Dorman, Collins, & Brey, 1990). In California,
Project TEACH (Teacher Education to Achieve Comprehensive Health) was organized
to assist college faculty who were teaching a required preservice health
course for elementary and secondary education majors (Lovato & Rybar,
1995).

At the national level, the Centers for Disease Control and Prevention
has provided funding to several organizations to aid in preventing serious
health problems, including HIV disease, among college students. Both the
American Association for Health Education (AAHE) and the American Association
of Colleges for Teacher Education (AACTE) are engaged in projects that
involve teacher education students.

AAHE, in the third year of its project, is developing model programs
for infusing HIV prevention education into preservice teacher preparation
and is working to establish state policies that promote health education
for elementary and middle school teachers. For additional information,
contact AAHE, 1900 Association Drive, Reston, VA 22091; 703-476-3420; http://www.hiv@aahperd.org

AACTE, with over 700 schools, colleges, and departments of education
(SCDE) as members, is in the second year of a 5-year initiative to influence
the institutionalization of HIV/AIDS prevention education in SCDEs. Among
activities planned for AACTE's Build a Future Without AIDS project are
development of various types of educational materials for teacher education
faculty to incorporate into their classes; sponsored discussions of the
role of health education in standards for teacher preparation and licensure;
dissemination of resources electronically; and provision of HIV/AIDS resource
materials to faculty and deans. For additional information, contact AACTE,
Build a Future Without AIDS, One Dupont Circle, Suite 610, Washington,
DC 20036; 202-293-2450; http://www.aacte.org/%20new/project.html

Centers for Disease Control and Prevention. (1988, January 29). Guidelines
for effective school health education to prevent the spread of AIDS. Morbidity
and Mortality Weekly Report, 37(Suppl. No. S-2), 1-14.

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